Exam 15 - Addiction

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Questions and Answers

In the context of aging, which factor contributes to the increased risk of substance misuse?

Physiologic and sociologic changes (correct)

Technological advancements

Improved drug metabolism

Increased physical activity

Which demographic primarily accounts for the 70% of alcohol-related deaths?

Males (correct)

Older adults

Adolescents

Females

What characterizes the early stages of substance dependence?

Users rely on the substance solely to feel normal.

Users frequently consume substances without experiencing withdrawal.

Social isolation and legal issues are common, but health declines are not evident.

Tolerance develops, and users experience negative effects and mood swings. (correct)

During which stage of dependence do individuals often experience withdrawal symptoms and use substances to feel 'normal'?

Middle stage Signup and view all the answers

Which statement about the late stage of substance dependence is accurate?

Users often associate only with dealers or fellow users and show severe impairment. Signup and view all the answers

Which personality traits are commonly associated with an addictive personality?

Experiencing low tolerance for stress and negative self-image. Signup and view all the answers

What is a common behavioral change during the middle stage of substance use dependence?

Use of the substance to feel 'normal' Signup and view all the answers

Which statement accurately reflects the impact of alcohol on the central nervous system?

Alcohol affects higher brain centers before influencing physical coordination Signup and view all the answers

What is often a consequence of relationships during the middle stage of substance dependence?

Lying and stealing become prevalent behaviors Signup and view all the answers

What characterizes the late stage of substance dependence?

Near-constant drug use to escape emotional pain Signup and view all the answers

What symptom is least likely associated with alcohol withdrawal syndrome?

Increased Focus Signup and view all the answers

Which statement about Fetal Alcohol Syndrome is incorrect?

There is a specific amount of alcohol that guarantees the condition. Signup and view all the answers

Which statement accurately describes the effects of chronic alcohol use?

It can lead to both Korsakoff psychosis and Wernicke encephalopathy. Signup and view all the answers

What is the typical time frame for symptoms of delirium tremens to occur after cessation of alcohol use?

1 to 4 days after cessation Signup and view all the answers

Which electrolyte imbalance is commonly associated with heavy alcohol consumption according to its diuretic effect?

Potassium Signup and view all the answers

Which physiological signs may indicate a patient is using methamphetamine?

Excessive gum and tooth erosion Signup and view all the answers

What is an essential part of the detoxification care plan for an addicted patient?

Creating a controlled environment for observation Signup and view all the answers

What common misconception might lead to a false-positive drug screening result?

Consuming foods like poppy seeds prior to testing Signup and view all the answers

Which intervention is NOT appropriate when caring for a patient with disorientation during detoxification?

Keeping the environment brightly lit and noisy Signup and view all the answers

What is the main purpose of disulfiram (Antabuse) in treating alcohol dependence?

To encourage abstinence through aversion conditioning Signup and view all the answers

Which of the following best describes the role of group therapy in substance abuse recovery?

It fosters an emotionally supportive environment to address substance abuse consequences. Signup and view all the answers

What differentiates club drugs from other types of substances abused?

They are commonly taken for euphoric effects in social settings. Signup and view all the answers

What is a significant concern regarding the misuse of prescription medications?

They are often shared or traded among individuals. Signup and view all the answers

In a treatment setting, why is family involvement considered important?

It helps the patient and family grow together. Signup and view all the answers

What is one potential negative effect of chronic substance abuse on the limbic system?

Potential permanent damage to emotional control and memory Signup and view all the answers

What serious side effect is associated with the sudden withdrawal from barbiturates?

Seizures or status epilepticus Signup and view all the answers

What type of facility typically offers services focused on detoxification from substances?

Residential treatment centers Signup and view all the answers

What is the primary goal of treatment following detoxification?

Rebuilding social skills without drug use Signup and view all the answers

What is a characteristic of flunitrazepam (Rohypnol) that contributes to its misuse?

It is odorless, tasteless, and colorless. Signup and view all the answers

What is true regarding the prescription history of benzodiazepines such as Valium?

Valium was consistently the most prescribed antianxiety agent until 1981. Signup and view all the answers

What withdrawal symptom is typically experienced about 6 hours after the last dose of opioids like morphine or heroin?

Flulike symptoms and body aches Signup and view all the answers

What is the primary role of methadone in treating opioid addiction?

To suppress withdrawal symptoms Signup and view all the answers

Study Notes

Addiction: Key Elements and Stages

Addiction components: Excessive use/abuse, psychological disturbance, decline in social/economic function, uncontrollable use (dependence).
Multiple addictions: Possible to have more than one addiction simultaneously (e.g., alcoholism, smoking, gambling).
Alcohol consumption: 87.4% of adults (18+) consumed alcohol in the past year; 6% have alcohol use disorder. Earlier drinking ages (14 or younger) correlate with higher alcoholism risk (44%). Alcohol abuse is increasing in older adults. Alcohol use and related deaths more common in males. Alcohol is a major factor in motor vehicle accidents.

Types of Substance Abuse

Illicit drug use: 10% of US population reported illicit drug use in the prior month in 2015; marijuana was the most common. Federal drug laws were updated to better regulate drugs. The Drug Enforcement Agency (DEA) is the primary enforcer for these laws.
Addictive personality traits: Low tolerance for stress, dependency, low self-esteem, insecurity, depression. It is unclear if these traits are present prior to addiction or are a result of it.

Stages of Dependence

Early stages: Tolerance develops as use increases; physical symptoms appear (insomnia, anxiety, cramps); user might decrease or stop, but relapse is common; family/friends voice concerns, but user might deny issues, isolate themselves, or socialize with other users. Absenteeism problems at work/school, legal issues (DUI), and financial difficulties are present
Middle stages: Moderate impairment; difficulties decreasing or stopping usage, followed by heavier use; withdrawal symptoms occur when substance use is stopped; user uses substance to maintain a "normal" state; deterioration of family/friend relationships, significant physical health issues (weight changes, GI problems, STIs), and job loss.
Late Stages: Severe impairment in all areas of functioning; Nearly constant drug use to avoid pain; significant medical problems (liver disease, pancreatitis, malnutrition), neglect of personal hygiene; higher risk of HIV/Hepatitis B/C or other infections; suicidal/homicidal ideation, denial, manipulative behaviors, unemployment, homelessness.

Alcoholism: Etiology and Associated Disorders

Prevalence: Alcoholism is a significant public health concern (second only to heart disease and cancer).
Causes: Multifactorial; biological factors (genetic predisposition, enzyme deficiencies), and psychological theories are possible. Certain ethnicities (Asian, Native American, Inuit) have higher rates than the general population while others (Jewish, Mormon, Muslim) have lower rates.
Fetal Alcohol Syndrome (FAS): Maternal alcohol consumption during pregnancy can cause severe birth defects like mental retardation, growth disorders, craniofacial abnormalities, and other birth defects as well as miscarriages and/or stillbirths. Even low levels of consumption can have adverse effects.
Alcohol Withdrawal Syndrome (AWS): Occurs when alcohol use stops suddenly; risk factors include age, history of delirium tremens, malnutrition and other health conditions. symptoms range from mild to dangerous (seizures, hallucinations).
Delirium Tremens (DTs): Serious complication of AWS caused by excessive alcohol consumption; associated high risk of death; symptoms are significant and severe.
Korsakoff Psychosis and Wernicke Encephalopathy: Brain disorders from chronic alcoholism and vitamin B1 deficiency; symptoms include severe issues with short-term memory, disorientation, and possibly confabulation.

Nursing Process and Interventions

Assessment: Includes subjective data (use patterns, last use), objective data (physical assessment, vital signs), and screening tools. Important to note past treatment/abstinence and possible co-occurring conditions.
Diagnostic testing: Blood/urine screens for substances, liver enzymes, nutrient levels (B vitamins, magnesium).
Patient problems: Address emotional and physical needs.
Detoxification: Safe supervision in a controlled environment.
Rehabilitation: Focuses on abstinence, address individual issues, and involves family support. Tools such as Alcoholics Anonymous and 12-Step programs, residential treatment centers, individual and group therapy are common.

Drug Abuse: Types and Consequences

Prescription and OTC drug abuse: Significant threat; involves misuse or abuse of prescribed/non-prescribed drugs for non-medical reasons.
Club/street drugs: Commonly abused (cocaine, amphetamines, hallucinogens). Causes various side effects and potential for severe dependence.
Depressants: Alcohol, sedative-hypnotic medications, opioid analgesics (barbiturates, benzodiazepines, etc.); tolerance/dependency is common including withdrawal issues.
Opioid analgesics: Abuse frequently; symptoms include respiratory depression, pinpoint pupils, stupor/coma. Withdrawal can be extremely difficult.
Stimulants: Caffeine, nicotine, cocaine, amphetamines, etc. Short-term and potentially devastating long term effects; severe dependence is possible. Withdrawal symptoms include craving, agitation, and depression.
Hallucinogens: PCP, LSD, MDMA, ketamine, mescaline, psilocybin; altering perceptions and thoughts, sometimes severe symptoms and psychological issues from severe use
Cannabis: Marijuana, concentrated resin; side effects include distorted perception, difficulty with problem-solving/memory/learning. Chronic use may result in several physical and psychological issues.
Inhalants: Solvents, glues, aerosols, refrigerants; possible severe and/or irreversible brain/organ damage.

Chemically Impaired Nurses:

Prevalence: Estimates indicate a substantial prevalence of addiction in nurses.
Warning signs: Many of the general warning signs of substance abuse also apply to nurses. Includes changes in work habits, documentation, or interactions with patients and colleagues, as well potentially requiring to work shifts that improve access to substances.
Impact: Can put patients at risk for injury, medication errors, slower recovery.
Reporting: The role of colleagues in reporting is crucial; anonymous reporting is often possible. Use of a journal for observations is necessary for recollection later.
Treatment and support: Referral to state-operated peer assistance programs can provide support and treatment while maintaining professional license.

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Description

This quiz explores the essential components and stages of addiction, including substance abuse and the impact of psychological factors. It highlights statistics on alcohol consumption and illicit drug use in the United States, as well as the implications of addictive personality traits. Test your knowledge on these critical issues surrounding addiction.